The present disclosure relates to improvements in sutures and suturing techniques, and more particularly to a welder and method of welding for making high-strength fused suture loops during endoscopic surgical procedures.
In surgical procedures, a suture is typically used to stitch or secure the edges of tissue together to maintain them in proximity until healing is substantially completed. The suture is generally directed through the portions of the tissue to be joined and formed into a single loop or stitch, which is then knotted in order to maintain the wound edges in the appropriate relationship to each other for healing to occur. In this manner, a series of stitches of substantially uniform tension can be made in tissue. Because the stitches are individual and separate, the removal of one stitch does not require removal of them all or cause the remaining stitches to loosen. However, each individual stitch requires an individual knot or some other stitch-closing device for securing the stitch around the wound.
It is sometimes necessary or desirable to close a wound site with sutures without having to form knots or incorporate loop-closing devices in the sutures, such as, for example, in surgical repair of delicate organs or tissues, where the repair site is relatively small or restricted. Apparatuses and methods for fusing suture loops have therefore also been provided. A fused suture loop must provide the appropriate tension on the wound edges and the appropriate strength to maintain the wound edges in sufficient proximity for a sufficient time to allow healing to occur.
Polymer sutures are particularly amenable to various fusing or joining processes, such as, for example, welding, whereby sections of the sutures can be fused together upon application of sufficient heat to the sections to cause partial melting and fusion of the sections. U.S. Pat. No. 5,893,880, for example, discloses a fused loop of an elongated material, such as a surgical suture, and apparatus for making the loop. Portions of one or more segments to be joined together are fused in a welding process to form a welded joint. The shear area of the fused portion of the joint determines the strength of the joint and is thus preferably relatively large. Various configurations for the welding apparatus facilitate the creation of relatively large fused portions of the joint by maximizing contact between at least one of the welding members of the apparatus and at least one of the segments to be joined.
What is still desired is an apparatus and a method of welding sutures so that high-strength fused suture loops are provided. Preferably, the apparatus and method will provide for ease of suture management before, after and during welding of the suture. In addition, the apparatus and method will preferably allow endoscopic suture welding. Futhermore, it is desired that the apparatus and method will provide a fused loop of an elongated material, such as a polymeric suture material, which has a strength in the joint region which is at least equal to, if not greater than, the strength of the parent material.
The present disclosure, accordingly, provides an apparatus and method for creating a fused loop of an elongated material, such as a polymeric suture material. The apparatus comprises a suture welder including a jaw assembly and a heater element. The jaw assembly includes a first jaw for receiving a first suture segment, and a second jaw for receiving a second suture segment so that the second suture segment is adjacent the first suture segment. The heater element is positioned relative to the jaws, and is adapted to be positioned between and melt at least adjacent surfaces of the overlapping first and second suture segments so that the suture segments can be pressed together and bonded.
The present disclosure also provides a method of welding suture segments. The method includes positioning suture segments adjacent to and on opposite sides of a heater element, and energizing the heater element such that portions of the suture segments in contact with the heater element melt. The method also includes clamping the suture segments together until the melted portions cool, resulting in an inter-segment bond, and then releasing the bonded suture segments.
These and other features of the present disclosure will be more fully appreciated with reference to the following detailed description which is to be read in conjunction with the attached drawings.